A 64-year-old woman was
referred to the outpatient urogynecological department because she had
difficulty urinating for one month and needed catheterization. On pelvic
examination, there was a 3-cm bulging in the anterior vagina. Ultrasonography
followed by abdominal and pelvic magnetic resonance imaging revealed a 4.5-cm
cystic mass surrounding the urethra and the mass was not connected to the
urethra (Panel A, arrows). Urethrocystoscopy and intravenous pyelography also showed
no relationship between the mass and the urethra. Excision of the paraurethral mass
was performed (Panel B). The histopathological analysis confirmed the diagnosis
of benign Müllerian cyst lined by endocervical-like, mucin-producing columnar
epithelium. The woman resumed normal voiding immediately after operation and had
no recurrence at 6-month follow-up. Müllerian cysts are usually small and asymptomatic
and require no treatment. If they are symptomatic and need to be removed, it is
important to obtain information about the cysts and adjacent structures preoperatively.
一名64歲的婦女因無法排尿一個月而需要導尿，因此被轉診至婦女泌尿科門診。進行骨盆檢查時，前陰道有一個3公分的凸起。超音波檢查後再進行腹部和骨盆核磁共振檢查，均顯示尿道周圍有一個4.5公分的囊狀腫塊，囊腫並未與尿道相連（圖A，箭頭）。尿道膀胱鏡檢查和靜脈腎盂造影也未發現囊腫與尿道之間的關係。由於患者無法解尿，於是我們切除了尿道旁的腫塊（圖B）。組織病理學分析證實了診斷為良性穆勒氏囊腫（Müllerian cysts）的診斷。患者在手術後立即恢復了正常的排尿，並且在6個月的復診時沒有復發的情況。穆勒氏囊腫通常很小且無症狀，不需要治療。然而若穆勒氏囊腫引起患者症狀，就會需要被切除，手術前詳細評估並獲取有關囊腫和鄰近結構的資料，有助於手術順利進行。
